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A little update.
Posted: 25 May 2014 11:17 PM   [ Ignore ]   [ # 16 ]
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TimB - 25 May 2014 09:35 PM

On second thought, since they are only going on a correlation of decreased anencephaly since the introduction of folic acid additives to food, it seems to me that it could alternatively or also be that sperm is defective in males with low folic acid levels.

So add rule number 3) guys with viable semen, who have any hope of ever fucking a woman who is capable of reproduction, should not only use a damn sturdy rubber if they want to prevent pregnancy, but should also make sure that their own diet is consistently rich in folic acid, in case they don’t prevent pregnancy.

Will most guys follow such rules?  Very doubtful.  But at least, if they subsequently father an anencephalic baby, they will know that they may have caused it.

Maybe condoms should have folic acid tablets included in the package. I don’t know, however, whether men would be any more likely to take the folic acid than they are to use a condom, especially in a non committed relationship. Most never know in what condition any resulting babies are born.

Lois

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Posted: 26 May 2014 08:21 AM   [ Ignore ]   [ # 17 ]
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So, again, after, at least, 22 years, where is the effective research that has lead to reports that indicate ways to avoid having a baby without a brain, other than to suggest taking folic acid?

I think this illustrates a common but inappropriate expectation of science that feeds a lot of disenchantment with it, as well as some of the conspiracy theorizing associated with medicine. Science has advanced our knowledge in a way that has allowed us to better our own health to a degree unprecedented in human history. In a couple of centuries, we have improved the length and quality of human life more than in all the preceding millennia of our existence. We have eliminated entire diseases (e.g. smallpox), and nearly eliminated many others (and would have except for the intransigence of human fear and stupidity that fuels resistance to vaccination programs). Terrible new scourges have arisen, such as HIV, and yet in a few decades we have made great progress controlling them (sadly, mostly in countries able to afford the fruits of scientific research, but that is a problem with our economic systems, not with science). Bubonic plague devastated enormous parts of the world unchecked for many centuries, by comparison. It is hard to argue that science has not been stunningly successful in improving human health.

Yet that cane easily lead to an overestimation of our abilities. The low-hanging fruit have been picked, and today massive research studies are considered successful if they can explain 15% of the variation in the occurrence of some disease. But that seems inadequate to most people, and leaves the impression that the research isn’t able to figure out “the cause” of whatever problem is being studies. And unfortunately, this often leads people to reliance on unscientific approaches to dealing with health problems, which supports a tremendously profitable snake oil industry.

The fact that these small clusters of cases, which as has already been pointed out and accepted may be statistical anomalies without any single common cause, or the basic problem of anencephaly cannot be solved in a couple of decades leads to the suggestion that either the methods of science aren’t working or that scientists aren’t trying hard enough. That view seems to me more a function of unrealistic expectations than evidence of a failure of science or scientists. Of course, we should care about these individuals and make efforts to find a way to prevent this problem from occurring. But we cannot do everything all at once, and as a proportion of the health problems we must devote our resources to understanding and solving, these clusters are tiny. The fact that they are tragic doesn’t necessarily mean we should do more, inevitably at the expense of efforts to understand and deal with much larger, equally tragic but often less dramatic health problems.

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Posted: 26 May 2014 02:07 PM   [ Ignore ]   [ # 18 ]
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Lois - 25 May 2014 11:17 PM

...
Maybe condoms should have folic acid tablets included in the package. I don’t know, however, whether men would be any more likely to take the folic acid than they are to use a condom, especially in a non committed relationship. Most never know in what condition any resulting babies are born.

Lois

Folic acid fortified condoms.  Clever idea.  As I looked in to it, however, I discovered that excessive folic acid supplementation can also, possibly, have some down sides.

http://www.health.harvard.edu/newsweek/the-ups-and-downs-of-folic-acid-fortification.htm

Too much folic acid may make colorectal cancers more likely.  High blood levels of folic acid may mask the detection of B-12 deficiencies and anemia.

Regular unfortified food sources of folic acid are not thought to be a problem.  Perhaps someone can figure out how to make condoms out of broccoli.  (Just kidding.  I don’t have that particular unrealistic expectation.)

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Posted: 26 May 2014 02:55 PM   [ Ignore ]   [ # 19 ]
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TimB - 26 May 2014 02:07 PM
Lois - 25 May 2014 11:17 PM

...
Maybe condoms should have folic acid tablets included in the package. I don’t know, however, whether men would be any more likely to take the folic acid than they are to use a condom, especially in a non committed relationship. Most never know in what condition any resulting babies are born.

Lois

Folic acid fortified condoms.  Clever idea.  As I looked in to it, however, I discovered that excessive folic acid supplementation can also, possibly, have some down sides.

http://www.health.harvard.edu/newsweek/the-ups-and-downs-of-folic-acid-fortification.htm

Too much folic acid may make colorectal cancers more likely.  High blood levels of folic acid may mask the detection of B-12 deficiencies and anemia.

Regular unfortified food sources of folic acid are not thought to be a problem.  Perhaps someone can figure out how to make condoms out of broccoli.  (Just kidding.  I don’t have that particular unrealistic expectation.)

Now there’s an idea worth pursuing! You may be onto something! wink

Lois

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Posted: 26 May 2014 03:06 PM   [ Ignore ]   [ # 20 ]
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mckenzievmd - 26 May 2014 08:21 AM

So, again, after, at least, 22 years, where is the effective research that has lead to reports that indicate ways to avoid having a baby without a brain, other than to suggest taking folic acid?

I think this illustrates a common but inappropriate expectation of science that feeds a lot of disenchantment with it, as well as some of the conspiracy theorizing associated with medicine…

...The fact that these small clusters of cases, which as has already been pointed out and accepted may be statistical anomalies without any single common cause, or the basic problem of anencephaly cannot be solved in a couple of decades leads to the suggestion that either the methods of science aren’t working or that scientists aren’t trying hard enough. That view seems to me more a function of unrealistic expectations than evidence of a failure of science or scientists. Of course, we should care about these individuals and make efforts to find a way to prevent this problem from occurring. But we cannot do everything all at once, and as a proportion of the health problems we must devote our resources to understanding and solving, these clusters are tiny. The fact that they are tragic doesn’t necessarily mean we should do more, inevitably at the expense of efforts to understand and deal with much larger, equally tragic but often less dramatic health problems.


I am not disenchanted with science, in general, nor have I promoted any conspiracy theories, here, that I am aware of.  (Though I do think it is ironic that a food supplement, with supplements so often berated in this forum area, has been scientifically determined to be the best way that we know of to address the dramatic problems of anencephalic births.)

I also recognize that resources for health research are not unlimited and that ideally cold hard rational determinations about the appropriations of such resources should be made.  (Although I also realize that the actual appropriations of such resources are more often than not, determined by the possibility of profit.  That is not a conspiracy theory.  It is just a recognition that we live in a capitalistic society. And probably, we are, generally, better off, than we might otherwise be, for it.)

Still, I don’t know the cost/benefit analysis of not addressing anencephaly more effectively, but I wonder if the costs of the lifetime of care of anencephalic persons has been figured in to the cold hard equation.  Maybe, most people assume that a baby born without brains parts will quickly die and go away.  Some don’t, and are hidden away from society’s general consciousness, in institutions, well in to adulthood, and sometimes, even, old age.

Also, I have pointed out a problem with public education about what the general public should know to potentially better address the occurrence of anencephalic births.  This is not a failure on the part of science or researchers.  But when statistically anomalous clusters of anencephaly occur, and the public shows interest, it seems to me an opportunity for SOMEBODY to educate the public on the specifics of what we do know and what can be done about it.  (And not stop with assurances that it is most likely a statistical phenomena of no common cause, implying that there is really no need to further attend to the issue.)

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Posted: 27 May 2014 06:41 PM   [ Ignore ]   [ # 21 ]
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nor have I promoted any conspiracy theories, here, that I am aware of.  (Though I do think it is ironic that a food supplement, with supplements so often berated in this forum area, has been scientifically determined to be the best way that we know of to address the dramatic problems of anencephalic births.)

I wasn’t implying you have advanced any conspiracy theories, only that very similar complaints and reasoning are often used as support by those who do. I should have been clearer about that.

As for the idea that supplements are often “berated,” I think that mischaracterizes the situation. Those of us critical of supplements are critical specifically of claims made without appropriate supportive scientific evidence. There are many scientifically validated uses of dietary supplements, and the use of folic acid discussed here is one of them. There is nothing wrong with supplementation per se, and I don’t think anyone has suggested there is. It is simply that there is a pervasive sense in our culture, which appears in this forum as well, that their use can be assumed to be safe and beneficial regardless of the state of the evidence.

I guess I feel that if something appears to be a statistical anomaly, saying so is intended to reassure people that there is not some hidden danger they need to guard against. It isn’t intended to diminish the importance of the suffering of those afflicted, nor to suggest that what can be done to prevent it shouldn’t be done. But unfortunately, it is very difficult for most people to accept the idea of statistical clusters without any real meaning or value in guiding behavior, and it seems like part of the rational approach to managing health risks and allocating preventative resources which we both agree is desirable involves trying to explain why we shouldn’t do more than we are doing in some cases.

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Posted: 27 May 2014 07:10 PM   [ Ignore ]   [ # 22 ]
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mckenzievmd - 27 May 2014 06:41 PM

nor have I promoted any conspiracy theories, here, that I am aware of.  (Though I do think it is ironic that a food supplement, with supplements so often berated in this forum area, has been scientifically determined to be the best way that we know of to address the dramatic problems of anencephalic births.)

I wasn’t implying you have advanced any conspiracy theories, only that very similar complaints and reasoning are often used as support by those who do. I should have been clearer about that.

As for the idea that supplements are often “berated,” I think that mischaracterizes the situation. Those of us critical of supplements are critical specifically of claims made without appropriate supportive scientific evidence. There are many scientifically validated uses of dietary supplements, and the use of folic acid discussed here is one of them. There is nothing wrong with supplementation per se, and I don’t think anyone has suggested there is. It is simply that there is a pervasive sense in our culture, which appears in this forum as well, that their use can be assumed to be safe and beneficial regardless of the state of the evidence.

 

Granted.  But since humans tend to over-generalize, such over-generalizations can go both ways.  Thus a distorted sense of the value and safety of supplements can go either way, with persons who aren’t presented with, or don’t take in, the explicit subtleties of which supplements are of value, in which circumstances and when are they safe, and when they pose both the possibility of positive and negative results.

Hence, IMO, the irony.

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Posted: 27 May 2014 07:32 PM   [ Ignore ]   [ # 23 ]
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mckenzievmd - 27 May 2014 06:41 PM

...
I guess I feel that if something appears to be a statistical anomaly, saying so is intended to reassure people that there is not some hidden danger they need to guard against. It isn’t intended to diminish the importance of the suffering of those afflicted, nor to suggest that what can be done to prevent it shouldn’t be done. But unfortunately, it is very difficult for most people to accept the idea of statistical clusters without any real meaning or value in guiding behavior, and it seems like part of the rational approach to managing health risks and allocating preventative resources which we both agree is desirable involves trying to explain why we shouldn’t do more than we are doing in some cases.

I think that helping people understand the concept of how clusters of data points can occur by chance, is valuable.  I think that explaining why we shouldn’t do more than we are doing in some cases, is valuable (though it make rub many people the wrong way).  I think that recognizing the horror, grief, and sadness of others who are effected by adverse circumstances is valuable (though we can only, typically, take this in small doses).  I think that explicit rational advice/education, in terms of what we do know, that can, potentially avert the occasions for such experiences of horror, grief and sadness, is most valuable.  But as to this last point, I do not know what the best structure for that should be.  It just seems to me, that it does not happen as effectively as it might or should.

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As a fabrication of our own consciousness, our assignations of meaning are no less “real”, but since humans and the fabrications of our consciousness are routinely fraught with error, it makes sense, to me, to, sometimes, question such fabrications.

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Posted: 28 May 2014 08:50 PM   [ Ignore ]   [ # 24 ]
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I agree completely.

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